华西医学

华西医学

术前运动干预对后外侧入路全髋关节置换术的临床疗效观察

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目的 观察和探讨术前运动干预对全髋关节置换术(total hip replacement,THR)的临床疗效。 方法 2017 年 3 月—2018 年 1 月将 73 例在吉林大学第二医院骨关节外科行初次单侧 THR 的患者分为试验组(37 例,术前进行常规宣教和 4 周运动干预)和对照组(36 例,术前只进行常规宣教),术后两组进行同样的常规康复训练。在术前 4 周(T0)、术前 1 d(T1)、出院前(T2)、出院后 1 个月(T3)和 3 个月(T4)分别评估和比较两组患者的疼痛视觉模拟评分(Visual Analogue Scale,VAS),在 T0、T1、T3、T4 分别评估和比较两组患者的髋关节 Harris 评分和“起立-行走”计时测试(Time Up and Go,TUG)结果。 结果 试验组在 T1、T3 和 T4 的 TUG 用时分别为(14.59±3.15)、(13.61±2.76)、(12.49±2.37)s,对照组分别为(16.31±3.31)、(15.25±3.08)、(14.22±2.65)s,干预后各时间点组间差异均有统计学意义(P<0.05);在 VAS 和 Harris 评分上,试验组与对照组在术后不同时间节点均有较大改善(P<0.05),但两组间比较差异无统计学意义(P>0.05)。 结论 术前运动干预能有效提高 THR 患者出院后的步行能力,降低跌倒风险,但并未降低术后疼痛程度和提高出院后的髋关节 Harris 评分。

Objective To investigate and explore the clinical effect of preoperative exercise intervention on total hip arthroplasty. Methods Seventy-three patients who underwent primary unilateral total hip replacement (THR) in the Orthopedics Department, the Second Hospital of Jilin University between March 2017 and January 2018 were divided into 2 groups: treatment group (n=37) and control group (n=36). Patients in treatment group received exercise intervention and routine education since 4 weeks before surgery; the control group just received routine education before surgery and both groups underwent the same routine rehabilitation training. The Visual Analogue Scale (VAS) was evaluated and compared separately between the two groups at 4 weeks before surgery (T0), 1 day before surgery (T1), before discharge (T2), 1 month after discharge (T3), and 3 months after discharge (T4). The results of Hip Harris score and Time Up and Go test (TUG) were evaluated and compared separately between the two groups at T0, T1, T3 and T4. Results Time of TUG of the treatment group and the control group at T1, T3 and T4 were (14.59±3.15) vs. (16.31±3.31) s, (13.61±2.76)vs. (15.25±3.08) s, (12.49±2.37)vs. (14.22±2.65) s, respectively, and the differences between the two groups at T1, T3 and T4 were all statistically significant (P<0.05). In terms of VAS and Harris scores, both groups showed significant improvement after surgery at different time nodes (P<0.05), but the differences between the two groups was not statistically significant (P>0.05). Conclusion Preoperative exercise intervention can effectively improve the walking ability of THR patients and reduce the risk of falls after discharge, but it did not reduce postoperative pain or improve postoperative hip Harris score after discharge.

关键词: 术前运动干预; 康复训练; 全髋关节置换术

Key words: Preoperative exercise intervention; Rehabilitation training; Total hip replacement

引用本文: 易江, 刘忠良, 魏彦龙, 刘鸿. 术前运动干预对后外侧入路全髋关节置换术的临床疗效观察. 华西医学, 2018, 33(10): 1242-1246. doi: 10.7507/1002-0179.201806051 复制

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